Overcoming Internet Addiction For Dummies. David N. Greenfield

to the Internet and have little or no withdrawal. Indeed, if getting through withdrawal or detoxing from the Internet, video games, or other screen behavior were sufficient, then no one who discontinued Internet or video game overuse would be experience addicted behavior again or experience a relapse, but this isn’t the case.

      Triggers and relapse

      Triggers are part of every addiction. A trigger is a psychological tickle that excites the reward system in your brain, which remembers the pleasure it felt when it engaged in the addictive behavior. I say “remembers” because part of the reward system includes the hippocampus, which is the part of the brain’s limbic system that is responsible for memory. The other interesting thing to note is that a trigger can elicit an anticipation response for getting that dopamine hit, and in many cases, that anticipatory dopamine hit can be twice as innervating as the dopamine hit from the actual behavior. A trigger is a powerful reminder of a past pleasure and can lead to a complete relapse into an addiction pattern.

Relapse is straightforward — it involves the reactivation of an addiction pattern. Sometimes relapse occurs for no obvious reason, and sometimes it occurs because of a clearly identified trigger. Triggers can be reminders of the addiction or pleasure found in the behavior, or they can be an emotion or a physical need of some type, including being tired, sad, lonely, or hungry. Basically, any imbalance in our well-being can be an indirect trigger for relapse. A big trigger for Internet addicts can simply be boredom, or simply seeing their screen device.

      

Some of the most common triggers can be memorized using the acronym HALTS: Hungry, Angry, Lonely, Tired, or Stressed. I would add that there are many other potential triggers as well, which often include proximity to our screen device, reacting to a time of day, or having something frustrating happen to us.

      

It’s important to note that relapse does not mean failure. Addiction often includes many attempts at recovery before success can be achieved; with Internet and technology addiction, there is an added complexity in that one must define what constitutes a relapse. Because it would be difficult to avoid screen use completely, a different definition of relapse must be defined for each person; typically, this includes deciding on a reasonable and healthy amount of total screen use, including a time limit or avoidance of specific content areas such social media, video gaming, pornography, YouTube, or other highly compelling websites or apps. The goal here is mediated and sustainable Internet and screen use, not abstinence of all screens, because that is impractical.

      Comparing physiological dependence versus addiction

      Physiological dependence involves the body (and brain) becoming used to a substance or a behavior. It is most typically associated with drugs and alcohol, and withdrawal is often medically treatable as a temporary condition that requires monitoring and possible pharmacological intervention. With certain types of physiological withdrawal, such as with alcohol, care must be taken to ensure against medical problems. With process and behavioral addiction such as Internet and technology addiction, some physiological withdrawal still occurs, but medical supervision and intervention are typically not needed. That does not mean professional guidance from a mental health or addiction professional is not needed — this may be necessary, and sometimes medications may be utilized to assist in both the withdrawal and recovery processes (see Chapters 11, 12, and 13 for more on diagnosis, self-help, and treatment).

Although there are notable withdrawal effects with Internet and technology addiction, these are typically short-lived (a matter of weeks). It is hard to separate physiological dependence from psychological or behavioral dependence, as the mind and body are not actually separate, but rather are an integrated system — addiction always affects both. However, physiological dependence often has to do with other organ systems of the body besides the central nervous system, and it accounts for the immediate physical withdrawal symptoms that we see with drugs and alcohol for a period after discontinuing a substance (symptoms that may require medical intervention).

      

Physiological dependence is not addiction; addiction is always a more complex, biopsychosocial process that involves numerous aspects of physical, behavioral, and psychological functioning.

      Looking at addiction as a mind and body phenomenon

      

Addiction is always a mind-body phenomenon and typically involves numerous aspects of our functioning. You cannot have an addiction without impacting life functioning in some way. Obviously, addictions vary in intensity and life impact, and so there are differences regarding the need for, and type of, treatments. The main thing to remember is that addiction always creates some consequence for how one lives and functions in their life, and always produces limitations, compensations, and challenges that are both physiological and emotional. We are often unaware of how impactful our addictions can be, and Internet addiction is no exception. Most of our patients are in some degree of denial regarding how impactful the addiction is for them and how it has limited and affected their life, which, as noted earlier, can be frustrating to loved ones.

      Discovering how addiction is a normal medical problem of living

      

As mentioned earlier in this chapter, addiction is really a part of normal brain reaction and functioning and is hardwired into our brain’s development. We’re designed to engage in pleasurable behaviors that were originally linked to enhance our survival, such as food and sex. Nature created the reward system in our brains (and in most mammalian brains) to facilitate our engaging in survival behaviors that are linked to pleasurable dopamine. These ancient parts of our brains are what make us all susceptible to addiction. The old stereotype that you become addicted only if you have an “addictive personality” is not based on sound science; the fact is that if you have a brain, you have some susceptibility to addiction.

Granted, there are genetic, epigenetic, and environmental contributing factors to addiction, but as I’ve said, the basic potential for addiction is hardwired into all of us. There is always an evolutionary part to addiction, where modern pleasurable triggers such as drugs, alcohol, calorie-dense foods, pornography, the Internet, video games, social media, shopping, and gambling all piggyback on those original dopamine survival pathways.

      Addiction is never solely about willpower, character, motivation, or honesty. Society often labels an addict as having deficiencies in these areas because the addict may appear to be displaying socially undesirable behavior. Addiction is a neurobiological disorder with significant psychological, social, spiritual, and physical impacts; no one chooses to be an addict to any substance or behavior (although they do have to choose not to be one). An understandable error is often made by those who love an addict. I see parents and family members become angry at their loved one for being an addict and engaging in negative behaviors that are typical of addicts. For instance, addicts almost always lie. Mainly, they lie to themselves in the form of rationalization and denial. This is necessary to continue their addictive behavior. After all, how can you be an addict and at the same time be honest with yourself that you are suffering from significant life consequences from watching 10 to 14 hours of YouTube, playing video games all day and night, never putting your smartphone down, or living on social media? It is hard to objectively see the deterioration in your relationships, your school or work performance, or your health, sleep, and personal hygiene.